MASSHEALTH & CMSP TERMINATE THOSE IN PREMIUM ARREARS

Beginning this month, MassHealth will be tightening its premium payment enforcement. Until now, MassHealth has stopped short of actually terminating members who fall behind on their premiums. However, beginning June 13, 2008 MassHealth and CMSP members who are 60 days past due on their premiums will be terminated. Members are given advance notice of this termination, and are offered a payment plan. Or, if circumstances have changed, the member may qualify for a nonpremium-paying benefit.

During the month of June 2008, MassHealth will place active members currently paying a premium with balances over 60 days past due as of June 1, 2008 on a payment plan. The payment plan provides the member additional time to pay the past due premiums while retaining benefits. To continue their benefits, members on a payment plan are required to pay their current month premium due and the payment-plan payment due each month. Members who do not pay their payment-plan payment in full by the due date on their invoice will be closed

How will members know they have been placed on a payment plan?

Members who have been placed on a payment plan in June 2008 will receive a special yellow insert in their June premium statement. The insert explains that MassHealth has placed the member on a payment plan so they can pay their past due balance. The insert also explains that the member must pay the full amount due (current month invoice and payment-plan payment due) in order to avoid loss of benefits.

How can you help members retain their benefits?

Encourage members to read and respond to all MassHealth mailings. Help reiterate the message that failure to pay their premiums on time will result in termination of their benefits. Direct members to MassHealth Customer Services at 1-800-841-2900 if they have specific questions or new information to report.

This bulletin provides more details (no longer available online, 3/16) -Adapted from e-mail “Termination for failure to pay MassHealth premiums”, Kim Simonian, MPH, Partners HealthCare Community Benefit Programs, June 11, 2008 and Eligibility Operations Memo 08-08, “Premium Billing Changes: Nonpayment of MassHealth, Commonwealth Care, and Children’s Medical Security Plan (CMSP) Premiums”, May 15, 2008.

06/08